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Tonsillectomy and Adenoidectomy for Obstructive Sleep Apnea and Snoring

Surgery Overview

Tonsillectomy and adenoidectomy are surgeries to remove the tonsils or adenoids. They are:

  • Used to treat obstructive sleep apnea (OSA) in children.
  • Rarely used to treat snoring in adults.
  • Not used to treat snoring in children.

The surgeries almost always require a stay in the hospital.

What To Expect

You may need to be watched closely after surgery. Your doctor or surgeon will watch:

  • Your blood oxygen levels for the first 2 to 3 nights after surgery.
  • For throat swelling, nerve injury, and sleepiness. Both the surgery itself and the medicines used can cause this.

Children who are younger than 3 years and who have other conditions, such as Down syndrome, are more likely to have problems from surgery. The most common is having a hard time breathing. These children may need oxygen therapy or continuous positive airway pressure (CPAP) therapy after surgery.

Why It Is Done

Your doctor may suggest these surgeries to treat sleep apnea if you have swollen tonsils and adenoids that block your airway during sleep. This is often the first treatment choice for children. That's because swollen tonsils and adenoids are often the cause of their sleep apnea.

How Well It Works

In children with sleep apnea, symptoms almost always improve within 6 months of surgery. Parents report a decrease in:

  • Snoring, coughing, and colds.
  • Hyperactivity and other behavior problems.
  • Restless sleep.

In children, these surgeries work well to treat obstructive sleep apnea 75% to 100% of the time. This is true even if the child is obese.footnote 1

Risks

Your throat will be sore after surgery. You may find it hard to eat and swallow for a few days. Other possible problems after surgery include:

  • Infection.
  • A lot of bleeding. (Some bleeding is expected.)

What To Think About

  • Snoring is not always thought to be a medical problem. Your insurance may not pay to treat it.
  • You can't predict if you will have snoring or breathing problems by simply looking at the size of your tonsils and adenoids.
  • If you have other health problems, your doctor may have to treat them before you have this surgery.
  • Tonsillectomy and adenoidectomy are the most common treatments for children who have obstructive sleep apnea.
  • Some children may need to be watched closely before surgery. This includes those who have certain health problems that cause bony deformities of the face and head. These problems include dwarfism and Down syndrome. It also includes children who have had a head injury or who have nervous and muscular disorders, such as cerebral palsy.
  • Children who have other conditions, such as asthma, upper respiratory infections, and heart problems, need to be treated for those problems before and after surgery. This can help reduce the chance of problems from surgery.

Related Information

References

Citations

  1. Schechter MS, et al. (2002). Technical report: Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 109(4): E69. Available online: http://www.pediatrics.org/cgi/content/full/109/4/e69.

Credits

Current as of: February 24, 2020

Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Hasmeena Kathuria, MD - Pulmonology, Critical Care Medicine, Sleep Medicine

To our patients and families,

We at Southern California Ear Nose & Throat hope you all are staying healthy and safe during this COVID-19 pandemic.  As your physicians, your health and safety are our primary concerns, and we encourage everyone’s compliance with relevant instructions from our government and physician leaders.

We are happy to report that we are in compliance with state and federal regulations and recommendations at this point in time to protect both you and our staff. We are not scheduling routine elective surgeries at this time; however, if there is a surgery that is necessary, we are available 24/7 as usual, and the surgery will be performed.

At our offices, we are scheduling routine patients at intervals such that those patients who wish to, may remain in their vehicles until it is time to be placed in an exam room.  Rooms will be treated between each patient with disinfectant. We will be taking temperatures of patients who want to be seen in the office, and screening questions will be asked.

Along with our continuing to see patients in our office, we are available by teleconference. While not every visit can be done via telemedicine, we will make every attempt to accommodate those who desire a telemedicine visit. It may well be that you are not sure if an in office visit is necessary; some visits are (like a child born with tongue tie who has feeding difficulty), while many visits can be postponed (like a routine check on ear tubes).  If you have any questions, please call the office so that we may guide you.

As usual, please do not hesitate to contact the office for refills and prescriptions as necessary.

As many of you may have heard, there is new data to suggest that the initial symptoms of COVID-19 may be a loss of taste and smell. In the event that you develop loss of taste or smell, please contact the office of your primary healthcare provider if you have these symptoms, as they are more able to determine if COVID-19 testing is appropriate. We will be available by teleconference to assist your primary healthcare provider should the need arise.  

In terms of audiology, Hearing aid fittings and adjustments will continue to be done. A separate entrance to the office in Long Beach will be used for these patients, and some patients may be seen at out Los Alamitos office so as to separate them in time and space from other patients, maintaining social distancing to the best of our abilities.

In general, we urge all our patients to get as much sleep as necessary and drink plenty of fluids. It is important to wash your hands with regular soap and water Try not to touch your nose and mouth.

If you are able, please consider blood donation at your nearest hospital as there is a national shortage!

We must all work together during these stressful times! 

Sincerely

SCENT

Nina Yoshpe MD, Ayal Willner MD, Namrata Varma DO, Christy Beranek PA, Garrett Sherman NP, Susan Eckhardt AuD